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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ShelliR on August 14, 2002, at 22:36:48
after a long trial with nardil and lamictal, I am probably giving up. This is sad, because twice in the past it has worked for me, but third time no such luck. I hadn't realized how anxious it was making me (I was up to 650mg--as advised by dr. ivan goldberg)
Am thinking of adding lithium to nardil. Has anyone had success by adding lithium to an ad for major depression, not Bipolar? Good effects, problems, whatever? This two year poop out of nardil is pulling me down further than I can tolerate for much longer.
Deciding between trying effexor more slowly or since I am already on nardil, slipping a trial of lithium in first.
Any advise would be appreciated.
Shelli
Posted by jsarirose on August 19, 2002, at 0:30:46
In reply to Lithium added to AD (Nardil), posted by ShelliR on August 14, 2002, at 22:36:48
> Am thinking of adding lithium to nardil. Has anyone had success by adding lithium to an ad for major depression, not Bipolar? Good effects, problems, whatever? This two year poop out of nardil is pulling me down further than I can tolerate for much longer.
I take Parnate (an MAOI) and was taking Lithium as the augmenting drug. I read that it is fairly successful as an augmentor and you don't need very high doses so usually you won't need to get the liver tests. I did fine on it but stopped because it does effect acne. I've had a terrible reaction from the Parnate and didn't want to aggravate my acne any more.
I switched to Lamictal but I'm still ramping up to a regular dose. I would recommend trying Lithium.
-Jessica
Posted by cybercafe on August 19, 2002, at 5:47:12
In reply to Re: Lithium added to AD (Nardil), posted by jsarirose on August 19, 2002, at 0:30:46
> I take Parnate (an MAOI) and was taking Lithium as the augmenting drug. I read that it is fairly successful as an augmentor and you don't need very high doses so usually you won't need to get the liver tests. I did fine on it but stopped because it does effect acne. I've had a terrible reaction from the Parnate and didn't want to aggravate my acne any more.
hey jess, what other, non-acne side effects did you get from lithium? ...
... i wonder if the mechanism is not hormonal, causing perhaps more free testosterone (that's how parnate increases libido??) .. though i guess that would lead to acne, possible body hair and head-hair loss? .... uh... and crazy female reproduction dysfunction, ovulatory dysfunction and polycystic ovaries .. stuff i am happy knowing nothing about :)
... and there are tons of treatments for hyperandrogenism ... www.aace.com/clin/guidelines/hyperandrogenism2001.pdf
... hmm... do you know what causes acne ? ... and how parnate would effect it? could it be a non-hormonal mechanism ?
....anyways.... would be nice if i could do something to help you out ...
Posted by jsarirose on August 19, 2002, at 12:52:50
In reply to Re: Lithium added to AD (Nardil), posted by cybercafe on August 19, 2002, at 5:47:12
> hey jess, what other, non-acne side effects did you get from lithium? ...
>
When I was using it to augment I didn't have any other side effects because I was at a low dose. When I took it years ago alone I did start getting a slight tremor because I was at a higher dose. Other than that I don't recall any other side effects (other than minor increased acne).> ... i wonder if the mechanism is not hormonal, causing perhaps more free testosterone (that's how parnate increases libido??) .. though i guess that would lead to acne, possible body hair and head-hair loss? .... uh... and crazy female reproduction dysfunction, ovulatory dysfunction and polycystic ovaries .. stuff i am happy knowing nothing about :)
>
> ... and there are tons of treatments for hyperandrogenism ... www.aace.com/clin/guidelines/hyperandrogenism2001.pdf
>
> ... hmm... do you know what causes acne ? ... and how parnate would effect it? could it be a non-hormonal mechanism ?
> ....anyways.... would be nice if i could do something to help you out ...
>Well, I do have PCOS (Poly Cystic Ovarian Syndrome) which causes excess small cysts on the ovaries. This in turn makes me produce excess androgens and testosterone. I take meds for it which help with the acne and facial hair, and help regulate my period (another symptom is lack of or infrequent periods). When I started Parnate my acne got seriously worse. And the more I took the worse it got. As I've been tapering down slowly my acne has been improving. It makes sense that the increased testosterone which has caused my increase in libido is also causing the increased acne. I never thought about that. I've found only rare examples of acne occuring in others - most don't mention it as a side effect.
Thanks for drawing the parallel. I guess I didn't think about the fact that it must act on testosterone since it's effecting the libido but would also cause other testosterone related side effects.
-Jessica
Posted by cybercafe on August 19, 2002, at 23:31:20
In reply to Re: Lithium added to AD (Nardil), posted by jsarirose on August 19, 2002, at 12:52:50
> When I was using it to augment I didn't have any other side effects because I was at a low dose. When I took it years ago alone I did start getting a slight tremor because I was at a higher dose. Other than that I don't recall any other side effects (other than minor increased acne).
awesome... no side effects is just what i was hoping to hear :)
> Well, I do have PCOS (Poly Cystic Ovarian Syndrome) which causes excess small cysts on the ovaries. This in turn makes me produce excess androgens and testosterone. I take meds for it
.... wow... if medicine weren't so disgusting, i would totally go into med school :)
... cutting people open, seems quite meaningful, but yuck :(>which help with the acne and facial hair, and help regulate my period (another symptom is lack of or infrequent periods). When I started
.... hmm... on the bright side.... you should have some excess muscle growth ... on the negative, T probably isn't good for cholesterol
>It makes sense that the increased testosterone which has caused my increase in libido is also causing the increased acne. I never thought about that. I've found only rare examples of acne occuring in others - most don't mention it as a side effect.
hmmm... how bad are anti-testosterone drugs considered in terms of side effects/dangerousness? i wondered if i might not do better with less testosterone ...
> Thanks for drawing the parallel. I guess I didn't think about the fact that it must act on testosterone since it's effecting the libido but would also cause other testosterone related side effects.
who knows... i mean when i was depressed or took SSRIs i had no libido but still experienced hair loss, acne, a hairy chest, and bizarre super strength ... so i imagine there are other mechanisms involved in libido as well...
but i figured you might want to look into it....
Posted by jsarirose on August 20, 2002, at 1:01:10
In reply to Re: Lithium added to AD (Nardil), posted by cybercafe on August 19, 2002, at 23:31:20
> hmmm... how bad are anti-testosterone drugs considered in terms of side effects/dangerousness? i wondered if i might not do better with less testosterone ...
>
> who knows... i mean when i was depressed or took SSRIs i had no libido but still experienced hair loss, acne, a hairy chest, and bizarre super strength ... so i imagine there are other mechanisms involved in libido as well...
>
> but i figured you might want to look into it....
>
There aren't really anti-testosterone drugs as much as drugs you can take that help regulate your hormones. The easiest if you're not trying to get pregnant (and are female) is the pill. That's currently what I'm taking to regulate.I don't think testosterone is related to the SSRI low libido effect. One of my doctors that was really great and up on all the latest studies was paying attention to a study about zinc and PMS. She surmised that since Prozac leached zinc from the body, by taking enough to replace what's lost (180-240mg), it might help libido. When I did this it worked great. The only down side is that 180-240mg of Zinc is a lot and it makes you nauseas unless you're very careful about taking it with a full meal. You also have to do it daily.
And some anti-depressents also made my acne worse, but I don't know if it was testosterone related. There must be other factors as well.
I agree physiology and pharmacology would be an interesting field. I could never get through the schooling though.
-Jessica
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